The Senior Squeeze

The lights went out for 10 minutes at Country Villa East nursing home in South L.A., and more than 200 nursing homes across California. No lack of electricity caused last weeks blackout. Rather, an odd bedfellow coalition of Big Labor, nursing home owners and patient advocates turned off the switches to warn of possible catastrophic cuts looming because of the state budget crisis.

With Californias $38 billion deficit, Country Villa East is just one of more than 1,100 homes across the state threatened by potential cuts to Medi-Cal reimbursement of nursing homes, once the Sacramento budget standoff is resolved. In his budget in May, Gov. Gray Davis proposed 15 percent cuts  estimated to save the state $2.6 billion.

Country Villa Easts administrator Richard Vogel said the facility would be looking at all cost-cutting options, including lowering the wages of employees across the board. Both options, he said, are potentially disastrous.

Last weeks protest, which brought some elderly patients out chanting their support in the parking lot, was the latest effort of California United for Nursing Home Care to stave off the cuts. The coalition was organized by the two former blood rivals  the powerful Service Employees International Union and an association of nursing home operators.

Carey Smith works as a certified nursing assistant at Country Villa East, where the starting pay for CNAs is between $8.15 and $8.36 per hour. On an average day she cares for eight residents, doing everything from brushing their teeth and bathing them to changing their diapers. You have to work two jobs to afford doing this, to survive, she said. There are times when you come up short on certain bills.

Officials with SEIU Local 434B, which represents long-term care workers, say the coalition will open up the once bolt-closed door to unionization at facilities statewide that have joined the alliance. Last month the coalition brought more than 2,000 workers, nursing home residents and their families to a Sacramento protest rally. The coalition has also run two weeks of paid advertisements in targeted Republican legislative districts and leafleted political functions.

At Wednesdays blackout, coalition members seemed optimistic that  due in part to their lobbying activities  the nursing home cuts could be removed from a final state budget. But officials with the SEIU also sounded a note of caution: Its not over till its over, said Beth Capell, an SEIU lobbyist.

While the SEIU clearly wants to protect its union jobs, the industry itself  already under pressure from the rising costs of health care and the aging of the baby boomer generation  says any reduction in state reimbursements would threaten the very survival of its facilities. There really isnt anything that can go  theres not any fat. Were a very efficient, lean organization as it is, said Michael Torgan, vice president of Country Villa Health Services, which owns and operates 23 nursing home facilities in Southern California, including Country Villa East.

Apart from sending a strong message to Sacramento, Wednesdays blackout showed the dawn of a new relationship between industry employers and the combative SEIU Local 434B. While only roughly 20 percent of nursing homes have chosen to join the coalition, the change has not been lost on those who have. The industry and union share a long history of battles over the union organizing attempts.

It was, in part, the history of this conflict that led the two unlikely partners to join forces last fall, months before cuts to Medi-Cal reimbursements were proposed in Sacramento. While SEIU enjoys immense political power in California (it represents more than 550,000 employees in this state alone), employers were often able to block organizing efforts. Only 7 percent of the industry in Los Angeles County is unionized.

Until recently, SEIU organizers intent on unionizing a nursing home facility would fight just to get a foot in the door. In the cases where they did, they were often forced out when employers called police to the scene. Organizers would wait in parking lots or show up at workers homes, because they couldnt talk to them at the workplace, said Steve Trossman, spokesperson for SEIU. From beginning to end it was very confrontational and uncomfortable for everybody involved, he added.

Access has been crucial for mobilizing workers to fight the budget cuts. Since the governors May proposal, both Senate and Assembly Budget Committees restored funding to nursing homes. This makes Pat McGinnis, director of California Advocates for Nursing Home Reform, a patient advocacy group, confident that cuts wont be put in place. Everything on paper says it wont happen, she said. But coalition members and legislators in Sacramento say its still too early to tell.

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